The proposed work is a continuation of the Stanford Five City Project, which has the following three aspects: 1. A demonstration project: to develop and implement a community health education program, combining materials directed at general audiences and delivered via the mass media with materials directed at specific audiences delivered via workshops, classes, and similar methods under the combined auspices of Stanford and local community organizations, which is directed at lowering the cardiovascular risk of the entire populations of Salinas and Monterey. 2. A field trial: to test the efficacy of this community-wide education program in the control of a. cardiovascular risk factors, using periodic surveys of persons aged 12-74 residing in randomly selected households, as well as unobtrusive techniques, to contrast relevant attitudes, knowledge, behavior, and risk factor levels in Salinas and Monterey with those in Modesto and San Luis Obispo; and b. cardiovascular disease events, using a continuous surveillance system to contrast rates of cause-specific morbidity and mortality in Salinas and Monterey with those in Modesto, San Luis Obispo, and Santa Maria. 3. A natural history study: to examine secular trends in rates of fatal and nonfatal cardiovascular disease, and to assess possible determinants of these trends using the survey system specified above. The study design calls for six years of educational intervention and eight years of survey and surveillance evaluation; the original grant was awarded in 1978 for five years. This proposal is to continue funding of the project to its planned completion in 1986 plus one year of additional funding for data analysis and publication.